With the search for Alzheimer’s drugs foundering, tech firms try to offer solutions

LAS VEGAS — The drug industry’s foundering search for an Alzheimer’s cure is fueling a parallel quest by technology companies to help patients and family caregivers cope with the disease by using virtual reality software, robotics, and novel communication tools.

Several companies engaged in the effort gathered here on Wednesday to deliver a unified message: Waiting for pharma to deliver a miracle is a recipe for financial Armageddon, as the cost of treating Alzheimer’s is expected to quadruple, to more than $1 trillion in the U.S. by 2030, if no breakthrough treatments reach the market.

The solution is not simply developing tools to manage patient symptoms, but to deliver better support to family caregivers who are collectively spending more than $500 billion annually to care for elderly relatives.

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“If we do not support the role of family caregivers and value them in this process, there is nothing we can do to bend the cost curve beyond what we’re doing,” said Thomas Riley, chief executive of Seniorlink, which developed a digital communication platform to help coordinate care for Alzheimer’s patients.

Technology firms are also selling digital products to help patients: A company called Dthera Sciences has built a therapy that uses music and images to help patients recover memories. The product analyzes facial expressions to monitor the emotional impact on patients and discover the sounds and visuals that provide the greatest relief. Earlier this year, Dthera received breakthrough device designation from the Food and Drug Administration, which provides an expedited pathway for the product’s approval.

Another firm, Ageless Innovation, has developed robotic cats and dogs that help to treat the depression and social isolation that so often afflicts people with Alzheimer’s. Ted Fischer, the company’s CEO, said Wednesday that research conducted by Pace University showed the products resulted in better patient outcomes across several measures, including a reduction in hospitalizations. “And it produces joy and meaningful connections for these patients,” Fischer said.

The pharmaceutical industry has racked up a long list of failures in recent years, with many drug candidates following a similar narrative. A promising treatment in early-stage research turns out to be a flop in late-stage trials, putting investors, patients, and caregivers on a roller coaster that always ends in disappointment and a return to the drawing board.

Fischer and other technology executives gathered here said their products are neither panaceas nor substitutes for a hoped-for pharmaceutical breakthrough that could reverse or prevent the symptoms of the disease. But they also urged public and private funders to step up investments in technology solutions that, in the short term, represent the best option for patients and families.

Carrie Shaw, chief executive of Embodied Labs, said the fear and stigma of Alzheimer’s has undermined the development of tools to help families, clinicians, and payers confront the disease in a meaningful way. “We’re afraid of it, so we’re not addressing it,” she said, adding that more investment is needed to diagnose the onset of the disease at an earlier stage, to ensure more effective treatment.

Her company developed a virtual reality program to educate caregivers about the disease and help them understand its impact on their relatives. The product immerses users in various scenarios Alzheimer’s patients and caregivers commonly face — from the loss of cognitive function, to changes in family relationships, to caregiver burnout.

“We not only go inside their lives, but inside their bodies, so they actually know what it’s like to have this disease,” Shaw said.

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Effective training and education for caregivers is especially important as the population ages, dramatically increasing the need for Alzheimer’s treatment as government investment in nursing home beds continues to decline.

Riley, the CEO of Seniorlink, said that means care will be increasingly delivered in home settings, where technology can help facilitate access to timely information and care. Seniorlink’s communication platform, called Vela, is a digital messaging service that can be used by all the family members, clinicians, and service providers involved in a patient’s care. Similar to workplace platforms like Slack, it lets the parties communicate in real time to address emergent problems and share information about changes in a patient’s condition and level of need.

Riley said the company is using analytics to help recognize patterns in patients’ symptoms, in an effort to flag optimal interventions for caregivers. He cautioned, however, that such technology should be used only to augment human care — not replace it.

“Money always rushes to technology,” he said. “But what technology gives you is data that humans still have to act on. And to act on it, they have to be able to trust it.”

Of the 10 subjects, each got a different set of putative therapies. The therapies sound like something you’d get at Whole Foods: gluten-free diet, probiotics, grass-fed beef, organic chicken, fish oil, CoQ10, yoga, music, meditation, fasting, etc. It’s based on a shaky notion — that monotherapies have failed, so we should try a whole bunch of therapies at once. There’s no control group, the researcher seems to have evaluated the subjects’ responses to treatment qualitatively in 7 cases, and the conclusions go far beyond any reasonable interpretation of these meager results. And yet, today it is being commercialized and there are practitioners of it all over the country — all based on this dubious study.

I’d like to hear comments on the research of Dr. Bredesen which he described in his book, “The End of Alzheimer’s”, the results on the first 10 patients to which he applied his protocol (9 of the 10 recovered), and the recent paper in which he described results to date on 100 patients treated by doctors trained in his protocol (all showed improvement).

I would not call this a trial. Of the 10 subjects, each got a different set of putative therapies. The therapies sound like something you’d get at Whole Foods: gluten-free diet, probiotics, grass-fed beef, organic chicken, fish oil, CoQ10, yoga, music, meditation, fasting, etc. At best, I’d call this a study, and not one that should be taken very seriously. It’s based on a shaky notion — that monotherapies have failed, so we should try a whole bunch of therapies at once. There’s no control group, the researcher seems to have evaluated the subjects’ responses to treatment qualitatively in 7 cases, and the conclusions go far beyond any reasonable interpretation of these meager results. And yet, today it is being commercialized and there are practitioners of it all over the country — all based on this dubious study.

As someone who has been an Alzheimer’s caregiver for over 7 years, I’m disgusted by putative tech solutions for AD. These are just gimmicks for extracting VC money. The most useful things I’ve found are installing 20 wall-mounted grab bars and four floor-to-ceiling grab bars. Equally useful are the wireless chair and bed alarms. Friction tape on the floors is also useful. Robotic dogs? I’d laugh if it wasn’t so pathetic. At least the era of “brain games” seems to be on its way out.

That said, there are areas where progress may be made in reducing the future prevalence of AD. Sleep apnea is strongly associated with AD, but unfortunately there have been no longitudinal studies to establish the direction of the arrow of causation. We need those studies. There are over a dozen smartphone apps for detecting SA by listening to snoring. Today, we don’t know the contribution of SA to AD, but it could be big and treating SA may lower the prevalence of AD. It’s like where we were with smoking in the 19th century — many physicians suspected smoking is a major cause of lung cancer, but they didn’t have any studies to establish it.

Another one is the development of e-nose technology. I was surprised to learn how far this has advanced, including diagnosis of human disease. Most of these work by capturing small organic molecules in exhaled breath and creating a “breathprint” that can indicate physiologic changes associated with certain diseases. Early diagnosis of AD might not be useful because we don’t have a treatment, but maybe we need early diagnosis to help find treatments. For sure, early diagnosis with florbetapir is never going to be a routine procedure. An e-nose solution would be fast, simple, and cheap.

What these two have in common is that they are based on serious science. They are not gimmicks designed to separate ignorant VCs from their money.

This is a recent meta-analysis about the association between sleep apnea and AD. If you have AD, you are about 5 times more likely to have SA than someone without AD. That is a very strong association.